Prognostic Value of Sarcopenia Definitions and Outcomes Consortium Criteria in Older Patients With Heart Failure

Taisuke Nakade; Daichi Maeda; Yuya Matsue; Nobuyuki Kagiyama; Yudai Fujimoto; Tsutomu Sunayama; Taishi Dotare; Kentaro Jujo; Kazuya Saito; Kentaro Kamiya; Hiroshi Saito; Yuki Ogasahara; Emi Maekawa; Masaaki Konishi; Takeshi Kitai; Kentaro Iwata; Hiroshi Wada; Takatoshi Kasai; Hirofumi Nagamatsu; Shin-Ichi Momomura; Tohru Minamino

doi:10.1016/j.jamda.2024.105350

Prognostic Value of Sarcopenia Definitions and Outcomes Consortium Criteria in Older Patients With Heart Failure

J Am Med Dir Assoc. 2024 Nov 11:105350. doi: 10.1016/j.jamda.2024.105350. Online ahead of print.

Authors

Taisuke Nakade¹, Daichi Maeda², Yuya Matsue³, Nobuyuki Kagiyama⁴, Yudai Fujimoto¹, Tsutomu Sunayama¹, Taishi Dotare¹, Kentaro Jujo⁵, Kazuya Saito⁶, Kentaro Kamiya⁷, Hiroshi Saito⁸, Yuki Ogasahara⁹, Emi Maekawa¹⁰, Masaaki Konishi¹¹, Takeshi Kitai¹², Kentaro Iwata¹³, Hiroshi Wada¹⁴, Takatoshi Kasai¹⁵, Hirofumi Nagamatsu¹⁶, Shin-Ichi Momomura¹⁷, Tohru Minamino¹⁸

Affiliations

¹ Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
² Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. Electronic address: [email protected].
³ Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. Electronic address: [email protected].
⁴ Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Digital Health and Telemedicine R＆D, Juntendo University, Tokyo, Japan.
⁵ Department of Cardiology, Nishiarai Heart Centre Hospital, Tokyo, Japan.
⁶ Department of Rehabilitation, The Sakakibara Heart Institute of Okayama, Okayama, Japan.
⁷ Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.
⁸ Department of Rehabilitation, Kameda Medical Centre, Kamogawa, Japan.
⁹ Department of Nursing, The Sakakibara Heart Institute of Okayama, Okayama, Japan.
¹⁰ Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
¹¹ Division of Cardiology, Yokohama City University Medical Centre, Yokohama, Japan.
¹² Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan.
¹³ Department of Rehabilitation, Kobe City Medical Centre General Hospital, Kobe, Japan.
¹⁴ Department of Cardiovascular Medicine, Saitama Medical Centre, Jichii Medical University, Saitama, Japan.
¹⁵ Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
¹⁶ Department of Cardiology, Tokai University School of Medicine, Isehara, Japan.
¹⁷ Saitama Citizens Medical Centre, Saitama, Japan.
¹⁸ Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Tokyo, Japan.

PMID: 39542034
DOI: 10.1016/j.jamda.2024.105350

Abstract

Objectives: The Asian Working Group for Sarcopenia in 2019 (AWGS 2019) emphasized muscle mass measurements. In contrast, the Sarcopenia Definitions and Outcomes Consortium (SDOC) prioritizes functional strength and mobility. Therefore, this study aimed to compare the prognostic utility of the SDOC and AWGS 2019 criteria for all-cause mortality in older patients with heart failure.

Design: A post hoc analysis of the FRAGILE-HF study, a prospective, multicenter, observational study.

Setting and participants: Patients ≥65 years of age hospitalized for heart failure across 15 hospitals in Japan.

Methods: Sarcopenia was diagnosed according to the AWGS 2019 and SDOC definitions. According to the SDOC criteria and by integrating insights from previous research, patients were categorized into nonsarcopenia, possible sarcopenia, and sarcopenia groups. The primary outcome was 2-year mortality.

Results: Of the 1282 study patients, possible sarcopenia and sarcopenia were diagnosed in 357 and 786 individuals, respectively. Kaplan-Meier analysis revealed a significant difference between the groups. Adjusted Cox proportional hazards analysis indicated a significant stepwise association between sarcopenic status and mortality risk (possible sarcopenia: hazard ratio, 1.22; 95% CI, 0.66-2.28; P = .525; sarcopenia: hazard ratio, 1.89; 95% CI, 1.08-3.34; P = .027). When sarcopenia defined by the SDOC and AWGS 2019 criteria was added to the model incorporating conventional risk factors, no significant difference was observed in the prognostic capabilities between the 2 models (net reclassification improvement, -0.009; 95% CI, -0.193 to 0.174; P = .920, with areas under the receiver operating characteristic curve of 0.697 for SDOC and 0.703 for AWGS 2019; P = .675).

Conclusions and implications: Among older patients with heart failure, the SDOC criteria for sarcopenia diagnosis are useful for risk stratification and provide prognostic capabilities equivalent to those of the AWGS 2019 criteria.

Keywords: Heart failure; gait speed; grip strength; prognosis; sarcopenia.